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Elson S. Floyd College of Medicine


Curriculum by Program Year

Mix of clinical and classroom training, right from the start

The curriculum in the Elson S. Floyd College of Medicine prepares you to succeed in a wide range of health care environments. Partnerships with hospitals and clinics make possible a rich diversity of classroom and clinical experiences. Whether you practice in a large urban hospital or as the sole physician in a rural setting, you will know how to deliver health care that achieves outstanding outcomes for your patients and your community.

Years 1 and 2: Basic science and clinical training

In the first two years of medical school, you will study the foundational sciences for medicine, integrated with the fundamentals of clinical practice. Through classroom lessons based on clinical cases, as well as your own clinical experiences, you will build the foundational knowledge you need to succeed as a clinician.

First year
Intensive introductory training

Your medical education begins with 2-week intensive training program. You will learn the basics of taking patient history, taking vital signs, conducting a physical exam, and other fundamentals that every doctor needs to know—including learning about professionalism and ethics.

Immediate clinical experience

In your third week, your clinical experience begins.

Before you arrive, you will have the opportunity to rank your preferences among the four locations where you could complete your clinical clerkships. At the beginning of the program, you receive your assignment: Spokane, Tri-Cities, Vancouver, or Everett. During your third week, you will have your first intersession at your regional site.

This immediate immersion in clinical settings brings classroom lessons to life. By the time you have completed your first three weeks of medical school, you will understand how it feels to be a doctor.

You will return to this location often. During each of your first 2 years, you will complete at least 3 week-long clinical sessions at the regional site. (These are identified as “intersessions” throughout this website.) You will also complete your third- and fourth-year clinical clerkships at the same location.

Summer break

During the summer of your first year, you will enjoy a short break from scheduled classes. During that time, you will have opportunities to complete selectives in clinical and research settings. Your selectives could take place at the College or elsewhere.




Second year

Expect to broaden and deepen your knowledge of basic science in second-year courses. At the same time, look to gain even more experience in clinical settings. You learn how to support your clinical decisions with the scientific principles you learned in class.


In term 4 of your second year, you transition into your longitudinal integrated clerkship. You spend 70 percent of your time with preceptors and patients. In the remaining 30 percent of your time, you continue in classroom or scholarship activities.

Licensing exam, part 1 of 3

At the end of your second year, you will take the first part of a 3-part national test, the United States Medical Licensing Examination (USMLE). This portion tests your fundamental knowledge in the medical sciences. You must pass the USMLE before you can practice medicine as an MD in the United States.

Years 3 and 4: Clinical immersion

During the final two years of study, the focus of medical education shifts heavily to the clinical curriculum. You and your fellow students will move onto hospital wards and into clinics to function as junior members of the medical team. Closely supervised by practicing physicians or residents, you will diagnose and treat patients. You will put into practice the basic science knowledge and clinical skills learned during your first two years.

High level of interaction with top clinicians

In most medical education programs, third- and fourth-year students typically learn the most from residents—physicians-in-training who are only a year or two ahead of them in medical school. In the Elson S. Floyd College of Medicine, medical students train largely in community-based hospitals and clinics that don’t have large residency programs. As a result, you will learn primarily from seasoned clinicians in your third and fourth years.

Students in similar MD programs report that they develop a “sense of companionship” with their preceptors.1 They get more hands-on experience. They receive constant feedback from physicians with decades of experience and become trusted associates. They become more confident. They acquire the expertise of a resident long before they begin their residency.

Staying close to home

If you have roots in the state of Washington, you don’t have to worry that you’ll be sent beyond the border for your clinical clerkships. Throughout your medical education, your clinical experiences will take place in the state.

  1. “Community-based medical education: Is success a result of meaningful personal learning experiences?” by Len Kelly, Lucie Walters, David Rosenthal, Education for Health, 2014, Volume 27, Issue 1, pages 47-50
Third year

During your third year, you will experience all the key fields of medicine as part of your clinical clerkships. It’s a chance to test drive career options and find the field that’s the best fit for you.

What you do as a clinical clerk
  • Improve your history-taking and physical examination skills
  • Write orders on charts
  • Write progress notes
  • Present patients verbally to their medical team and faculty
  • Discuss issues with patients and their families
  • Perform procedures
Required longitudinal integrated clerkship, Year 3

Unlike traditional clerkships, in which medical students may briefly visit with patients while shadowing a mentor, Longitudinal Integrated Clerkships (LICs) allow students to follow patient cases from beginning to end. This model infuses the curriculum with meaning for students. It fosters bonds between the student and patient, as well as between the student and teacher.

“The curriculum must matter to the student and the student must matter to the curriculum.”

—Dr. David Hirsh, LIC director, Harvard Medical School

New and innovative approach
LICs are a relatively new and innovative concept in clinical learning. In the year 2000, only 5 medical schools in the U.S. reported having LICs. By 2014-15, LICs had been adopted at 44 LCME-accredited schools nationwide. The Elson S. Floyd College of Medicine faculty includes experts in the LIC model.  The College is proud to be one of a handful of U.S. medical schools that has adopted the LIC as its primary clinical training model for all students.

Advantages of LICs

  • Retaining empathy
    Medical educators theorize that students who do LIC clerkships retain empathy to a greater degree than students who participate in traditional clerkships.
  • Improving recall
    LICs allow students to interleave, or alternate between, topics and return to them at spaced intervals over weeks or months. According to learning theory, students better retain information learned in this context.
  • Building strong relationships with patients and preceptors
    As a student in one of the College’s clinical learning communities that include Everett, Spokane, Tri-Cities or Vancouver and locations close by, you will experience continuity in your experiences with patients and preceptors. This ongoing interaction allows you to build meaningful relationships. You will find that it helps you to:

    • Build self-confidence
    • Take ownership of your own learning
    • Take initiative in patient care environments
    • Trust in your growing capabilities
    • Participate more fully in patient care1
  1. Longitudinal Integrated Clerkships: Principles, Outcomes, Practical Tools and Future Directions. Hirsh and Poncelet, eds. Alliance for Clinical Education, Gegensatz Press.  2016.
Licensing exam, part 2 of 3

At the end of your third year, you will take the second part of the USMLE examination. This segment of the test assesses how well you can apply medical knowledge, skills and understanding of clinical science to care for patients while working in a supervised environment.

Fourth year

In your final year, you will focus on advanced clinical work, zeroing in on your areas of interest. For example, if you want to become an orthopedic surgeon, you might choose an elective in orthopedic surgery and allow a few extra weeks for the clerkship. That way, you’ll have extra experience to showcase when you apply for residency.

Required core clerkships and rotations, Year 4

You will receive training in emergency medicine and neurology, complete your leadership capstone project, and explore a range of other areas of medicine.

Elective rotations

Elective rotations take the form of either a consultative elective or a subinternship.

Consultative elective
You respond to consultation requests sent to a sub specialty service by physicians. You are the first to evaluate patients and present your findings and impressions to the sub specialty attending physician or fellow before giving that information to the original requesting physician.

You will work on the wards as an intern, but with more responsibilities than you had in your third year. You will be supervised more directly by a senior-level physician than before. You will be  given more leeway in decision-making and charting.

Applying to residency programs

During the first part of the fourth year, you will submit your applications through the National Residency Matching Program (NRMP). This organization is made up of key academic medical oversight agencies and medical student associations.

The process is similar to that of applying to medical school:

  • Apply: You send an application form, a personal statement, letters of recommendation, and USMLE test scores to the residency programs of your choice.
  • Interview: You go through a round of interviews.
  • Ranking: Both you and the residency programs to which you apply submit a ranking list.
  • Selection: You are matched with the highest-ranked residency program that has also lists you as desirable and acceptable.